ZRT SAMPLE TYPES
The only way to know if hormones are in balance is to test them. Therefore, it’s vital to partner with a lab that understands subtle differences between testing in different sample types and has both the experience and technology to deliver the most accurate results.
ZRT offers testing in 4 different sample types so you can choose the option that is best for you and your patient’s needs to achieve optimal clinical outcomes.

Suitable for:
- Assessing “free” (unbound to carrier proteins) hormone levels
- Monitoring hormone replacement given orally, topically, vaginally or via pellets
- Collecting multiple samples during a day, e.g., determining diurnal cortisol levels for adrenal stress assessment
Not suitable for:
- Monitoring sublingual/troche hormone replacement
- Patients with dry mouth, e.g., due to Sjögren’s Syndrome

Suitable for:
- Assessing total circulating hormone levels (free plus protein-bound)
- Patients with dry mouth and/or children who may have difficulty collecting saliva
- Monitoring hormone replacement therapy (oral, sublingual, pellet)
- Assessing thyroid health, fertility parameters, and cardiometabolic risk factors
Dried Blood Spot testing is superior to Serum for:
- Assessing interstitial tissue/capillary hormone levels reflecting topical or vaginal hormone supplementation
- Toxic and nutritional elements requiring a whole blood sample
- Self-collection of sample at home at a time convenient to the patient and avoiding a trip to the phlebotomist

Suitable for:
- Measuring steroid hormone metabolites, e.g., for breast cancer risk assessment
- Determining toxic element exposure and iodine/selenium sufficiency for thyroid health
- Determining diurnal cortisol production at 4 time points for stress assessment
- Assessing nocturnal and diurnal melatonin production
Not suitable for:
- Monitoring topical or intravaginal hormone replacement therapy

Suitable for:
- Assessing total circulating endogenous hormone levels (free plus protein-bound)
- Monitoring hormone replacement therapy (sublingual, patch, pellet)
- Assessing thyroid health
- Assessing analytes that cannot be determined in dried blood spot, e.g., ferritin
Not suitable for:
- Monitoring topical hormone replacement therapy (underestimates tissue uptake)
- Monitoring oral hormone replacement therapy (circulating metabolites interfere with immunoassays)
- Assessing analytes that require a whole blood sample, e.g., HbA1c or blood lead
Data Sheet: The Science of Saliva Testing